Thursday, September 30, 2010

Me, to the 89 year old I was admitting with chest pain:"I'm having a hard time believing you're 89." [Seriously, she looked the same age as the very old appearing 66 year old whose room I had just left.]

Her: "That's what they always say to me."

Me: "Well, you just look too good to be 89."

Her: "You should have seen me when I was younger."

Me: Chuckle.

Her: "I had so many boyfriends. And I knew just how far to go with them."

Tuesday, September 28, 2010

The first, which was not so pleasant:There is a special breed of person we see in the hospital not infrequently - the kind that actually enjoys being in the hospital. They think it's like this great place to come and relax for a few days. Even if there's not much wrong with them, they think they should be allowed to stay in the hospital as long as they want. I went to discharge a patient today (who honestly I could have sent home yesterday) and he suddenly got very mad and yelled at me that this hospital sucked and that he was going to go tell someone what he thought of this place and that he'd never come here again. I have been yelled at before when trying to send home people who do not want to leave, so I tried to reason with him about it, but he was not in a reasonable mood. Whatever. I got his paperwork done and moved on. Then, maybe 20 minutes later, I get a phone call from the nurse. Apparently the patient then started making threatening statements about me, saying that he hated me and "was going to get me." She called security. I then left a message for risk management. I certainly am not scared - I think he was just blowing off steam. But it is disconcerting to hear, especially from a fairly large man. I'm not sure what the resolution of this will be - another attending said that the hospital takes this very seriously. Supposedly, he wants to come to the montgomery center in the morning to tell someone what he thinks about the situation. Security will be standing by.

The second:I had a nearly cliche, something that only happens to doctors in the movies kind of experience today as well. I almost delivered a baby in the parking lot to the ER. I had just gotten to the ER to do an admission when I heard the ER nurses sort of freaking out and talking about needing a "precip kit." "Precip" meaning precipitous delivery, as in, a rapid delivery that happens somewhere like the ER parking lot. I followed them out to a van I had just passed on the way in. On the way in I thought I heard the spanish-speaking lady who got out of the van mention something about a baby, but I didn't see anyone else in the car so I didn't worry about it. The ER doctors and nurses, while totally competent and good at what they do, are just not as comfortable in the situation of trying to deliver a baby. So I go with them and pull on some sterile gloves. Our patient is lying on a trash bag in the back seat of a green van, clearly trying to breathe through her contraction. I check her cervix, find her to be not-quite-fully dilated, and tell everyone to take a big breath and get us a stretcher. At this point there are 4 or 5 doctors and at least that many nurses. I check her again after her contraction is over just to make sure I got it right. (I did.) We move her over to the stretcher and rush her inside. The nurses whisk her away to the labor floor, where she arrives just in time to deliver her healthy baby. Which I do think was better for all involved. But it would have been an even better story if I'd gotten to deliver the baby in the back seat of the green van.

Sunday, September 26, 2010

1. I got all the way to work this morning (early!) and was walking in the building when I realized that I had forgotten my pager. Sadly, this small (but annoying) piece of equipment is not one I can work without. I had to drive all the way back home to get it. Sigh.

2. Judah has started doing the sweetest things. Whenever he's nursing, he'll put his hand up and just try to feel the ends of my hair. He doesn't usually pull, but sort of runs his fingers through the ends as he's eating. It's adorable. When other people are holding him, he'll also shoot me this big grin, and then stick out his chubby hands and reach out for me to hold him. I love it.

3. The community revival started tonight. Jeff had this great idea to have a community-wide choir made up of people from all the church involved sing. I loved seeing (and hearing) all the voices (both white and black) joined together in song. Jeff actually gets his turn preaching tomorrow. Should be a great, amen-filled time.

4. A good friend is getting married and she had her lingerie shower yesterday. While I was out shopping for it on friday, I ran into someone I knew (the wife of a colleague). I was mortified and felt I had to explain why I was holding a (very tasteful) piece of lingerie. Even though I'm married and know that I'm allowed to buy lingerie, I was still totally embarrassed. I wonder if I'll ever get over this feeling.

Friday, September 24, 2010

I've been spending a lot of time recently hunched over my sewing machine. When Judah naps, I'll sneak in there to start cutting and piecing and ironing. (Pics to come later!) It's given me a lot of time to ponder why it is that I enjoy sewing so much. I think there are lots of reasons, but one big one really stuck out to me yesterday.

I love my job - I really do. But sometimes, at the end of a long day, I don't always have something to show what I accomplished. I'll spend my time at work, slowly working my way through all the floors in the hospital, trying to get everyone seen. I adjust medicines, start new ones, give IV fluids, and order tests all in hopes of trying to make my patients better than they were when they came in. But the nature of the world we live in is that our bodies decay and sometimes, in spite of my best efforts and the best of all medical technology, people continue to get worse.

At MUSC, just before graduation, each class invites some of their favorite professors to deliver lectures of advice and encouragement about our medical careers. I remember nearly nothing about what was said at these lectures except for one sentence delivered by a rather crusty professor of surgery. He told us that we should always mow our own lawns, because "some days I come home and mow the lawn and that's the only @#%! thing I've done all day."

I do not enjoy mowing the lawn. Thankfully, I have a husband who takes care of this. But I can definitely understand this professor's (crassly memorable) sentiment. Sewing accomplishes this same thing for me. It gives me something to do with my hands, the ability to actually create something and have something tangible to show for my work. When I spend a lot of time fighting what sometimes feels like a losing battle, I crave the sense of accomplishment that comes with holding an actual item in my hand that I made myself.

Apparently I've been doing a lot of baking this week. Before Jeff's birthday feast, I apparently got it in my head I wanted to make some kind of cookie. I'd seen this recipe for homemade oreos a long time ago on, you guessed it, Smitten Kitchen. I've never made a recipe from that sight that wasn't just awesome. These came together really quickly - whirred up in my food processor, then spooned onto cookie sheets. I wouldn't say that they tasted just like oreos, but in my opinion were far, far better. (And no surprise there, since these didn't contain high fructose or hydrogenated anything.)

Wednesday, September 22, 2010

My dear husband turned 33 last Tuesday. Since I was working that day, we realized a real celebration would be too hard to pull off well. Instead, we celebrated 1 week late. Since I was not working, that gave me plenty of time to prepare his annual birthday feast. I did nearly the same menu as last year, because, really why mess with something so tasty.

But the highlight was the dessert. Every year since we've been married, I've made Jeff a German chocolate cake for his birthday. This year I asked him a few weeks ago what he'd like, and he requested root beer float cupcakes. He'd had these on his mind ever since seeing them on the food network. We actually went to this cupcake place in Boston just so he could get one, but the person right in front of us ordered the last one. So last week I did a little "research" trying to find the perfect recipe. (This consisted of me making a few small batches of cupcakes to taste test.) The runner up was a recipe from the always delicious smitten kitchen. I actually preferred this one, because it had chocolate in it, and I'm always up for things that taste more like chocolate. Since it's not my birthday, I let someone else make the final call. The cupcake part was a recipe from guilty kitchen. It uses root beer extract (bought at walmart, near the vanilla) and really gives the cake a strong root beer flavor.

Most of the recipes I looked at called for a whipped cream frosting or root beer flavored frosting. I just did a good vanilla buttercream, to sort of mimic the ice cream portion of an actual float. They were a big hit. Everyone seemed to love them, especially the birthday boy. I had a little too much fun decorating them:

I have a feeling these are going to be part of birthday celebrations for years to come.

Monday, September 20, 2010

I'm reading a very interesting book right now called Expecting Adam. It's written by a mother who had a son with Down Syndrome, a mother who is a self-proclaimed atheist, staunch feminist, and strongly pro-choice. (And apparently now writes for "O" magazine.) It's a memoir of that pregnancy and her life as a graduate student at Harvard who not only had the audacity to get pregnant, but then also decided to carry to term a baby with Down Syndrome.

What amazes me is how well she can grasp the Truth and eloquently explain it, and yet still be so lost.

My favorite quote so far:"All I can say for sure is that whatever supernatural beings are operating around us, they are working from a priority list that is different than mine."

I look at the second part of that sentence and think, "Amen. Wow. She is so on point there."

Then I reread the first part and just sigh and shake my head. That's how it is throughout everything I've read so far - some of it just achingly beautiful and true. Some of it just makes you want to shake her out of the blindness she's living in. She did such a beautiful and hard thing when she decided to carry her baby to term. She says over and over how he has taught her so much and enriched her life in myriad ways. Then in the next breath defends all those who have chosen to live their lives without that blessing.

What's funny to me is that even though her expressed purposes are not to convince people that abortion is wrong or to have them understand that a loving God guided her down an unexpected path, through trials and dark, difficult times to a place of beauty, that is exactly the message she's given me: A reminder that his plans are better than mine, and that his ways are higher than my ways.

Thursday, September 16, 2010

I decided, upon some reflection, that I was dissatisfied with my post yesterday.

My first paragraph ended with me talking about wanting to be a good doctor. The second was an anecdote about how I was able to stay calm in an emergency and knew how to treat my patient. I feel like the juxtaposition of these may have made it seem like I was trying to prove I'm a good doctor or that I want everyone else to know that I always know what I'm doing.

Here's the thing:I don't always know what I'm doing. I'm constantly having to look stuff up, even stuff I feel like I should know. Even today one of the third year residents glanced over some orders I had written and pointed out an order that was obviously wrong. Oops. Tuesday I just realized that all my training really had taught me a lot - and that I could use what I knew and stay calm in a serious situation.

Here's the other thing:Knowing what to do in a situation like that doesn't make me a good doctor. It only makes me a competent one. Now, you can't be a good doctor without being competent, but there are plenty of competent doctors out there who aren't so great. I think it's fairly easy to be a competent doctor, but being a good doctor is much more difficult. It's not just knowing what to do; it's all the little things that make someone a good doctor - knowing what to say to a patient who is scared, being able to deliver bad news to a family in a kind way, graciously interacting with colleagues, being able to translate the complicated medical language we think in in a way that gives patients a true understanding of what is going on - these are the kinds of things it takes to be good. And the truly great doctors, I think, are those who really love their patients and figure out how to show them Jesus.

So that's what I'm aiming for. That is the kind of doctor I want to be. Not just competent.

Wednesday, September 15, 2010

I'm emerging from the busiest two work days I've ever had to try to take a little breath of air before going back under.

Being a working mom is hard. I guess I knew it would be. When I'm at work, I think about my little man and miss him and try to do everything I can to finish quickly. When it's almost 7 pm and I'm still seeing patients I just want to cry. When I'm home, I think back about my work day and hope I'm taking good care of my patients. I really want to be a good doctor. But I also really want to be a good mom.

One of my patients almost bled to death right in front of me yesterday. In many ways, seeing her pale face look up at me, asking me if she was going to die was a terrifying situation. The weird thing was that I wasn't scared. I knew what to do. I called our specialist, who came right away to control the bleeding. I got fluids in to her to raise her blood pressure. I got her a blood transfusion. Then she stopped breathing, so we got her intubated. She finally stabilized for the time being. But I am worried that we're not going to be able to fix this problem permanently.

Jeff and I went on a date by ourselves (!!) last night. We called one of our friends, a resident who is the year behind me and lives two houses down. He happily came over after we put Judah down and let Jeff and I go and have a little birthday date. We went to Chili's and had a wonderful conversation, drank some margarita and shared a molten chocolate cake. It was an excellent end to a very difficult day. I realized that we need to be more intentional about doing that more often.

It's now 6 am and I need to nurse Judah before going in to work. I'm going to try to get there a little early so maybe, hopefully I can finish work a little earlier today.

Tuesday, September 14, 2010

I was feeling inspired on Saturday. Or maybe I was just wanting to procrastinate from cleaning the house. Either way, I whipped up a couple more pairs of pants for Judah, this time in a larger size. I also tried to make the bum area a little more generous to accommodate the cloth diapers. I'm not sure I actually did that part right or if they just fit better since they're a larger size, but either way, I can tell these will be fitting him for a while. I also figured out a better way to sew these to make them actually reversible. The first pants I did are sort of reversible, but I probably wouldn't actually ever use them on the opposite side because of how they're finished. But these are truly reversible. I'll have to get a photo of what the other side looks like. I was also proud of myself because I didn't have quite enough of the lining fabric on either pair, but took a line from Tim Gunn a la Project Runway and "made it work."

The first pair were some USC gamecock pants for him to wear during football season. The reverse is this nice gray (same that I used in his hat.)

And next I used some fabric scraps I got when I ordered cute boy fabric from fabricworm.

Monday, September 13, 2010

We tried some solids again yesterday. I decided I was ready to see if he was ready. It did seem to go better this time. Although when I fed him today, he sort of passe about the whole thing. I'll just try again tomorrow. And instead of going the rice cereal route, I decided to make some homemade pear sauce. I actually thought it was delicious - especially with the addition of some vanilla extract and a little bit of balsamic. (Thank you, Smitten Kitchen)

He actually opened his mouth right up. Here he is trying to attack the spoon.

Toast the pecans in a dry skillet for a few minutes prior to grinding them in a food processor. Then toast the sesame seeds until they are browned. You have to watch them closely because they can burn quickly. Mix the remaining ingredients and put in a bowl.

I used 3 boneless, skinless chicken breasts, although the recipe calls for 6 pounds of assorted chicken pieces. Dip in buttermilk, then dredge in flour mixture. The recipe then says to dip in corn oil (gulp) and drain. Then put in a roasting pan. I just couldn't bring myself to do this dipping in oil business. Instead, I did a little drizzle of olive oil over the top.

Bake at 350. The recipe says for 1.5 hours, but with the boneless skinless breast it took maybe 45 minutes. Just check the temp.

I served mine with some stuffed zucchini and green beans from our garden.

Friday, September 10, 2010

I've been thinking hard the last few days about what I can write about.

And I got nothing.

I could write about the current cupcake-baking kick I'm on, but I have no beautiful photos of finished cupcakes to show you. Jeff requested root beer float cupcakes for his birthday this year, and I'm trying to figure out exactly how to make the tastiest, most root-beer-floatiest cupcakes I can. I'll let you know what I figure out.

I made some delicious pecan-sesame chicken for dinner last night, and I thought about posting the recipe, but that just seems boring. This isn't really a food blog and I don't want to just resort writing about what I'm eating.

I'm enjoying this mostly stay-at-home-mom-hood. I went to a women's bible study this morning at a local church, something I would have loved doing in the past but never could because I worked. But it's nice having a reason to get dressed and leave the house in the morning. Since some days I don't put on actual clothes until after lunch. Which I probably need to work on.

Judah's favorite thing to play with on his exersaucer is the little paper tag. He'll spend a long time quietly concentrating on that little blue tag. It cracks me up.

I made some pants for Judah right after he was born. They were, of course, enormous on him. Then I sort of forgot about them, until a couple of days ago. I'm glad I remembered them when I did because they just barely fit now. I still have maybe another week or two until he outgrows them. They look adorable on him and it made me very excited to make him some that are bigger. Photos to come.

So there you have it. Most of the random thoughts swirling around in my head. Hopefully I'll do something fun or have some deep insightful thought I can share in the next few days.

Tuesday, September 07, 2010

I've been working on Judah's baby book (which I'm doing on Shutterfly) the last few evenings after he goes to sleep. It's been a fun memory lane, going back through some of the old photos of him. I actually get a little teary-eyed when I notice how big he's gotten and how much he's changed. I actually miss that little baby we had then.

Which is just crazy, right?? Because he's still here, sleeping (or not) in his crib. I guess other moms out there can relate. I just keep loving Judah more and more and it's an incredible joy to watch him grow and get bigger. And now he's doing more and so much more interactive than he ever was when he was such a tiny thing. But I still miss that tiny little smooshy baby. Sigh.

Friday, September 03, 2010

We had an awesome water skiing trip this week, accompanied by two good friends, Jason and Sallie. One nice thing about my current job situation is that we can do things like randomly drive up to Seneca on a Tuesday to go skiing. And there's a certain grandmother who loves to watch Judah for us so he doesn't have to suffer the indignity that is his life jacket. The weather was perfect, with a bright blue sky.

I wish I could say I had taken the following pic, because I think it's cool. But I didn't. Jason did.

Jeff, in addition to being an excellent preacher, teacher, and all-around handsome guy, is an outstanding boat driver.

I'm not sure I've ever been under the train trestle on the lake with a train going overhead.

And the skiing? It was wonderful. The water was like glass.

Hopefully we'll have a few more trips out like this before it turns cold....

Thursday, September 02, 2010

I love how these photos came out - we had an impromptu photo session on the front lawn this morning. Between the softish light and my sweet, smiling boy, they ended up looking really great. (At least I think so.)

I took some really cute pictures of a FIVE month old Judah today. (5!!) You'll have to wait to see them because my husband is hogging our other computer to work on a little something he calls his "thesis."

As an aside - he just came down and quoted to me a sentence he had just written, of which he was particularly proud. I love the man I married in all his nerdy ways.

I know I just wrote how I was concerned about my milk supply and Judah not getting enough. Then on Tuesday we went up to my parent's house for a little end-of-summer boating fun. I weighed Judah on the postal scale at my mom's office.